Most evidence suggests that only a finite number of bacteria are responsible for dental caries and periodontal diseases. This knowledge led to the development of microbial tests which can identify suspected pathogens. Current evaluation of the diagnostic power of microbial tests has shown that they have a low sensitivity and a low prognostic value. Despite these shortcomings, there are valid indications for microbiological-based diagnosis. Salivary microbial tests for the detection of mutans streptococci and lactobacilli may be useful, for example, in young children, oligosialic patients, and orthodontic patients. These tests can be used to monitor the success of chemopreventive measures or compliance with dietary recommendations. Microbial diagnosis may also be valuable in the treatment of early-onset periodontitis or in subjects who respond poorly to periodontal therapy. The use of microbial tests to monitor the efficacy of chemotherapy or mechanical treatment is of particular interest.
References
1.
Alaluusua S., Asikainen S. (1988). Detection and distribution of Actinobacillus actinomycetemcomitans in the primary dentition. I Periodontol59:504-507.
2.
Alaluusua S., Renkonen O-V. (1983). Streptococcus mutans establishment and dental caries experience in children from 2 to 4 years old. Scand J Dent Res91:453-457.
3.
Alaluusua S., Savolainen J., Tuompo H., Gronroos L. (1984). Slide-scoring method for estimation of Streptococcus mutans levels in saliva. Scand J Dent Res92:127-133.
4.
Alaluusua S., Saarela M., Jousimies-Somer H., Asikainen S. (1993). Ribotyping shows intrafamilial similarity in Actinobacillus actinomycetemcomitans isolates. Oral Microbiol Immunol8:225-229.
5.
American Academy of Periodontology (1992). Glossary of periodontal terms. 3rd ed. Chicago: American Academy of Periodontology.
6.
American Dental Association (1939). Dental caries, findings and conclusions on its causes and control. The Advisory Committee on Research in Dental Caries. New York: Lancaster Press, Inc.
7.
Asikainen S., Alaluusua S., Saxen L. (1991a). Recovery of A. actinomycetemcomitans from teeth, tongue, and saliva. J Periodontol62:203-206.
8.
Asikainen S., Lai C.-H., Alaluusua S., Slots J. (1991b). Distribution of Actinobacillus actinomycetemcomitans serotypes in periodontal health and disease. Oral Microbiol Immunol6:115-118.
9.
Attström R., van der Velden U. (1993). Consensus report of session 1. In: Proceedings of the Ist European Workshop on Periodontology, Feb. 1-4, 1993. Ittingen CH, Lang NP, Karring T, editors. London: Quintessence Publishing Co., Ltd. pp. 120-126.
10.
Baehni P., Tsai C.-C, McArthur WP, Hammond BF, Taichman NS (1979). Interaction of inflammatory cells and oral microorganisms. VIII. Detection of leukotoxic activity of a plaque-derived Gram-negative microorganism. Infect Immun24:233-243.
11.
Baehni PC, Tsai C.-C, McArthur WP, Hammond BF, Taichman NS (1981). Leukotoxic activity in different strains of Actinobacillus actinomycetemcomitans. Arch Oral Biol26:671-676.
12.
Baker PJ, Butler R., Wikesjo UME (1991). Bacterial sampling by absorbent paper points. An in vitro study. J Periodontol62:142-146.
13.
Beck JD, Koch GG, Zambon JJ, Genco RJ, Tudor GE (1992). Evaluation of oral bacteria as risk indicators for periodontitis in older adults. J Periodontol63:93-99.
14.
Berkowitz R., lordan V. (1975). Similarity of bacteriocins of Streptococcus mutans from mother and infant. Arch Oral Biol20:725-730.
15.
Burt BA ( 1991). The distribution of periodontal destruction in the populations of non-industrialized countries. In: Risk markers for oral disease. Vol. 3. Periodontal diseases. Johnson NW, editor. Cambridge: Cambridge University Press, pp. 9-26.
16.
Buttner M. (1993) Der Mundflüssigkeitsgehalt an Streptococcus mutans bei Basler Kindern und Jugendlichen Schweiz Monatsschr Zahnmed103:409-412.
17.
Carlos JP ( 1978). Opening statements and orientation. In: Methods of caries prediction. Spec Suppl, Microbiol Abstr. Bacteriology. Bibby BG, Shern RJ, editors. Washington, DC: Information Retrieval Inc., pp. 1-2.
18.
Carlsson J., Grahnen H., Jonsson G. (1975). Lactobacilli and streptococci in the mouth of children. Caries Res9:333-339.
19.
Choi JI, Nakagawa T., Yamada S., Takazoe I., Okuda K. (1990). Clinical, microbiological and immunological studies on recurrent periodontal disease. J Clin Periodontol17:426-434.
20.
Christersson LA, Slots J., Rosling BG, Genco RJ (1985). Microbiological and clinical effects of surgical treatment of localized juvenile periodontitis. J Clin Periodontol12:465-476.
21.
Christersson LA, Fransson CL, Dunford RG, Zambon J.) (1992). Subgingival distribution of periodontal pathogenic microorganisms in adult periodontitis. J Periodontol63:418-425.
22.
Clarke JK (1924). On the bacterial factor in the aetiology of dental caries. Br J Exp Pathol5:141-147.
23.
Coykendall AL (1989). Classification and identification of the viridans streptococci. Clin Microbiol Rev2:315-328.
24.
Dahlén G., Renvert S., Wikström M., Egelberg J. (1990). Reproducibility of microbiological samples from periodontal pockets. J Clin Periodontol17:73-77.
25.
Davis GHG (1959). Lactobacilli of the human mouth. J Appl Bacteriol22:350-359.
26.
Dewhirst FE, Paster BJ (1991). DNA probe analyses for the detection of periodontopathic bacteria in clinical samples. In: Periodontal disease. Pathogens ε host immune responses. Hamada S, Holt SC, McGhee J, editors. Tokyo: Quintessence Publishing Co., Ltd., pp. 367-378.
27.
Dix K., Watanabe SM, McArdle S., Lee DI, Randolph C., Moncla B., et al. (1990). Species-specific oligodeoxynucleotide probes for the identification of periodontal bacteria. J Clin Microbiol28:319-323.
28.
Dzink JL, Socransky SS, Haffajee AD (1988). The predominant cultivable microbiota of active and inactive lesions of destructive periodontal diseases. J Clin Periodontol15:316-323.
29.
Edwardsson S. (1984). Bacteriological studies on deep areas of carious dentine. Odontol Revy25(Suppl 32).
30.
French CK, Savitt ED, Simon SL, Eklund SM, Chen MC, Klotz LC, et al. (1986). DNA probe detection of periodontal pathogens. Oral Microbiol Immunol1:58-62.
31.
Genco RJ, Zambon JJ, Christersson LA (1988). The origin of periodontal infections. Adv Dent Res2:245-259.
32.
Gmur R. ( 1988). Applicability of monoclonal antibodies to quantitatively monitor subgingival plaque for specific bacteria. Oral Microbiol Immunol3:187-191.
33.
Gmur R. ( 1995). Value of new serological probes for the study of putative periodontal pathogens (A survey after five years of application). 1st ed. Chicago: Quintessence Publishing Co., Inc.
34.
Gmur R., Guggenheim B. (1990). Monoclonal antibodies for the detection of periodontopathic bacteria. Arch Oral Biol35:145S-151S.
35.
Gmur R., Guggenheim B. (1994). Interdental supragingival plaque. A natural habitat of Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Campylobacter rectus, and Prevotella nigrescens. J Dent Res73:1421-1428.
36.
Gold W., Preston FB, Blechman H. (1973). The nature and amounts of bound glucose in dental plaque. I Periodontol44:263-268.
37.
Guggenheim B. (1968). Streptoococci of dental plaques. Caries Res2:147-163.
38.
Guggenheim B. (1970). Extracellular polysaccharides and microbial plaque. Int Dent J20:657-678.
39.
Gusberti FA, Syed SA, Lang NP ( 1988). Combined antibiotic (metronidazole) and mechanical treatment effects on the subgingival bacterial flora of sites with recurrent periodontal disease. J Clin Periodontol15:353-359.
40.
Haffajee AD, Socransky SS (1994). Microbial etiological agents of destructive periodontal diseases. Periodontology20005:78-111.
41.
Haffajee AD, Socransky SS, Ebersole JL, Smith DJ (1984). Clinical, microbiological and immunological features associated with the treatment of active periodontosis lesions. I Clin Periodontol11:600-618.
42.
Haffajee AD, Socransky SS, Smith C., Dibart S. (1991). Microbial risk indicators for periodontal attachment loss. J Periodont Res26:293-296.
43.
Hassell T., Harris E. (1995). Genetic influences in caries and periodontal diseases. Crit Rev Oral Biol Med6:319-342.
44.
Helfenstein U., Steiner M., Marthaler TM (1991). Caries prediction on the basis of past caries including pre-cavity lesions. Caries Res25:372-376.
45.
Howe PR, Hatch RE (1917). A study of the microorganisms of dental caries. J Med Res36:481-491.
46.
Isokangas P., Alanen P., Tiekso J. (1993). The clinician's ability to identify caries risk subjects without saliva tests-a pilot study. Community Dent Oral Epidemiol21:8-10.
47.
Kiel RA, Lang NP ( 1983). Effect of subgingival sampling techniques on periodontal microbiological culturing (abstract). J Dent Res62:247.
48.
Kilian M. (1978). Rapid identification of Actinomycetaceae and related bacteria. J Clin Microbiol8:127-133.
49.
Kligler IJ (1915). Oral microorganisms. J Allied Dent Soc10:141-166.
50.
Kohler B., Andreen I. (1994). Influence of caries-preventive measures in mothers on cariogenic bacteria and caries experience in their children. Arch Oral Biol39:907-911.
51.
Kolenbrander PE (1988). Intergeneric coaggregation among human oral bacteria and ecology of dental plaque. Ann Rev Microbiol42:627-656.
52.
Krasse B. (1988). Biological factors as indicators of future caries. Int Dent J38:219-225.
53.
Kulkarni GV, Chan KH, Sandham HJ (1989). An investigation into the use of restriction endonuclease analysis for the study of transmission of mutans streptococci. J Dent Res68:1155-1161.
54.
Kuramitsu HK, Yoneda M., Madden T. (1995). Proteases and collagenases of Porphyromonas gingivalis. Adv Dent Res9:37-40.
55.
Lai C.-H., Listgarten MA, Shirakawa M., Slots J. (1987). Bacteroides forsythus in adult periodontitis. Oral Microbiol Immunol2:152-157.
56.
Larmas M. (1975). A new dip-slide method for the counting of salivary lactobacilli. Proc Finn Dent Soc71:31-35.
57.
Laughon B., Syed SA, Loesche W.) (1982). API ZYM system for identification of Bacteroides spp, Capnocytophaga spp, and spirochetes of oral origin. J Clin Microbiol15:97-102.
58.
Lindhe J. (1989). Textbook of clinical periodontology. 2nd ed. Copenhagen: Munksgaard.
59.
Listgarten MA (1992). Microbiological testing in the diagnosis of periodontal disease. J Periodontol63:332-337.
60.
Listgarten MA, Helldén L. (1978). Relative distribution of bacteria at clinically healthy and periodontally diseased sites in humans. J Clin Periodontol5:115-132.
61.
Listgarten MA, Levin S., Schifter CC, Sullivan P., Evian CI, Rosenberg ES (1984). Comparative differential dark-field microscopy of subgingival bacteria from tooth surfaces with recent evidence of recurring periodontitis and from non-affected surfaces. J Periodontol55:398-401.
62.
Listgarten MA, Lai C.-H, Young V. (1993). Microbial composition and pattern of antibiotic resistance in subgingival microbial samples. J Periodontol64:155-161.
Loesche WJ (1986). The identification of bacteria associated with periodontal disease and dental caries by enzymatic methods. Oral Microbiol Immunol1:65-70.
65.
Loesche WJ, Lopatin DE, Giordano J., Alcoforado G., Hujoel P. (1992a). Comparison of the benzoyl-DL-arginine-naphtylamide (BANA) test, DNA probes, and immunological reagents for ability to detect anaerobic periodontal infections due to Porphgromonas gingivalis, Treponema denticola, and Bacteroides forsythus. J Clin Microbiol30:427-433.
66.
Loesche WJ, Lopatin DE, Stoll J., van Poperin N., Hujoel PP (1992b). Comparison of various detection methods for periodontopathic bacteria-Can culture be considered the primary reference standard? J Clin Microbiol30:370-376.
67.
Loos BG, van Winkelhoff A., Dunford R., Genco R., de Graaff J., Dickison D., et al. (1992). A statistical approach to the ecology of Porphyromonas gingivalis. J Dent Res71:353-358.
68.
Magnusson I., Lindhe J., Yoneyama T., Liljenberg B. (1984). Recolonization of a subgingival microbiota following scaling in deep pockets. J Clin Periodontol11:193-207.
69.
Magnusson I., Marks RG, Clark WB, Walker CB, Low SB, McArthur WP (1991). Clinical, microbiological and immunological characteristics of subjects with "refractory" periodontal disease. J Clin Periodontol18:291-299.
70.
Mandell RL (1984). A longitudinal microbiological investigation of Actinobacillus actinomycetemcomitans and Eikenella corrodens in juvenile periodontitis. Infect Immun45:778-780.
71.
Mandell RL, Tripodi LS, Savitt E., Goodson JM, Socransky SS (1986). The effect of treatment on Actinobacillus actinomycetemcomitans in localized juvenile periodontitis. ) Periodontol57:94-99.
72.
Marsh PD (1989). Host defenses and microbial homeostasis: Role of microbial interactions. J Dent Res68:1567-1575.
73.
McClure FJ, Hewitt WL (1946). The relation of penicillin to induced rat dental caries and oral L. acidophilus. J Dent Res25:441-443.
74.
Mclntosh J., Warwick JW, Lazarus-Barlow P. (1922). An investigation into the etiology of dental caries. 1: The nature of the destructive agent and the production of artificial caries. Br J Exp Pathol3:138-145.
75.
Miller A., Brunelle J., Carlos J., Brown L., Löe H. (1987). Oral health of United States adults. NIH Publication N°. 87-2868. Washington: US Department of Health and Human Services.
76.
Miller WD (1890). The micro-organisms of the human mouth. Basel: S. Karger, 1973.
77.
Mombelli A., McNabb H., Lang NP ( 1991a). Black-pigmenting Gram-negative bacteria in periodontal disease. I. Topographic distribution in the human dentition. J Periodont Res26:301-307.
78.
Mombelli A., McNabb H., Lang NP ( 1991b). Black-pigmenting Gram-negative bacteria in periodontal disease. II. Screening strategies for detection of P. gingivalis. J Periodont Res26:308-313.
79.
Moncla BJ, Braham P., Dix K., Watanabe S., Schwartz D. (1990). Use of synthetic oligonucleotide DNA probes for the identification of Bacteroides gingivalis. J Clin Microbiol28:324-327.
80.
Moncla BJ, Motley ST, Braham P., Ewing L., Adams TH, Vermeulen M.) (1991). Use of synthetic oligonucleotide DNA probes for identification and direct detection of Bacteroides forsythus in plaque samples. J Clin Microbiol29:2158-2162.
81.
Moore WEC, Holdeman H., Cato EP, Smibert RM, Burmeister JA, Palcanis KG, et al. (1985). Comparative bacteriology of juvenile periodontitis. Infect Immun48:507-519.
82.
Moore WE, Moore LH, Ranney RR, Smibert RM, Burmeister JA, Schenkein HA (1991). The microflora of periodontal sites showing active destructive progression. J Clin Periodontol18:729-739.
83.
Morishita T. (1929). Studies on dental caries, with special reference to aciduric organisms associated with this process. J Bacteriol18:181-198.
84.
Mousques T., Listgarten MA, Phillips RW (1980). Effect of scaling and root planing on the composition of the human subgingival microbial flora. J Periodont Res15:144-151
85.
Newbrun E. (1989). Cariology. 3rd ed. Chicago: Quintessence Publications Inc.
Orland FJ, Blayney JR, Harrison RW (1955). Experimental caries in germfree rats inoculated with enterococci. J Am Dent Assoc50:259-272.
88.
Pavicic Mjamp, van Winkelhoff AJ, Douque NH, Steures RWR, de Graaff J. (1994). Microbiological and clinical effects of metronidazole and amoxicillin in Actinobacillus actinomycetemcomitans-associated periodontitis. A 2-year evaluation. J Clin Periodontol21:107-112.
89.
Petit MDA, van Steenbergen TJM, Scholte LMH, van der Velden U., de Graaff J. (1993). Epidemiology and transmission of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans among children and their family members. A report of 4 surveys. J Clin Periodontol20:641-650.
90.
Pienihakkinen K. (1988). Screening for high caries increment in children. Proc Finn Dent Soc84(Suppl II): 1-76.
91.
Pilot T., Barmes DE, LeClercq MH, McCombie BJ, Sardo Infirri J. (1986). Periodontal conditions in adults, 35-44 years of age: An overview of CPITN data in the WHO Global Data Bank. Community Dent Oral Epidemiol14:310-312.
92.
Renvert S., Wikstrom M., Dahlén G., Slots ), Egelberg J (1990). Effect of root debridement on the elimination of Actinobacillus actinomycetemcomitans and Bacteroides gingivalis from periodontal pockets. J Clin Periodontol17:345-350.
93.
Renvert S., Wikström M., Helmersson M., Dahlen G., Claffey N. (1992). Comparative study of subgingival microbiological sampling techniques. J Periodontol63:797-801.
94.
Rodenburg JP, van Winkelhoff AJ, Winkel EG, Goene RJ, Abbas F., de Graaff J. (1990). Occurrence of Bacteroides gingivalis, Bacteroides intermedius and Actinobacillus actinomycetemcomitans in severe periodontitis in relation to age and treatment history. J Clin Periodontol17:392-399.
95.
Rodriguez FE (1930). A method of determining, quantitatively, the incidence of Lactobacillus acidophilus odontolyticus in the oral cavity. J Am Dent Assoc17:1711-1719.
96.
Rodriguez FE (1931). Quantitative incidence of Lactobacillus acidophilus in the oral cavity as a presumptive index of susceptibility to dental caries. J Am Dent Assoc18:2118-2135.
97.
Rogosa M., Mitchell JA, Wiseman RF (1951). A selective medium for the isolation and enumeration of oral lactobacilli. J Dent Res30:682-689.
98.
Russell RRB (1991). New methods for microbial screening. In: Risk markers for oral diseases. Vol 1. Dental caries. Johnson NW, editor. Cambridge: Cambridge University Press, pp. 327-339.
99.
Saglie FR (1991). Bacterial invasion and its role in the pathogenesis of periodontal disease. In: Periodontal disease. Pathogens ε host immune responses. Hamada S, Holt SC, McGhee J, editors. Tokyo: Quintessence Publishing Co., Ltd., pp. 27-40.
100.
Savitt ED, Strzempko MN, Vaccaro KK, Peros WJ, French CK (1988). Comparison of cultural methods and DNA probe analyses for the detection of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, and Bacteroides intermedius in subgingival plaque samples. J Periodontol59:431-438.
101.
Savitt ED, Darack AP, Killoy WJ, Lieberman MG (1991). Site selection criteria for microbiological testing of periodontal microorganisms. J Periodontol62:558-561.
102.
Schupbach P., Osterwalder V., Guggenheim B. (1995). Human root caries: Microbiota in plaque covering sound, carious and arrested carious root surfaces. Caries Res29:382-395.
103.
Simonson LG, Robinson PJ, Pranger RJ, Cohen ME, Morton HE (1992). Treponema denticola and Porphyromonas gingivalis as prognostic markers following periodontal treatment. J Periodontol63:270-273.
104.
Skaar DD, Wolff LF, Aeppli DM, Bloomquist CG, Liljemark WF (1992). A follow-up case report of Actinobacillus actinomycetemcomitans in human periodontal disease. J Clin Periodontol19:288-292.
105.
Slots J. (1981). Enzymatic characterization of some oral and nonoral Gram-negative bacteria with the API ZYM system. J Clin Microbiol14:288-294.
106.
Slots J. (1986). Bacterial specificity in adult periodontitis. A summary of recent work. J Clin Periodontol13:912-917.
107.
Slots J., Listgarten MA (1988). Bacteroides gingivalis, Bacteroides intermedius and Actinobacillus actinomycetemcomitans in human periodontal diseases. J Clin Periodontol15:85-93.
108.
Slots ), Rosling BG (1983). Suppression of the periodontopathic microflora in localized juvenile periodontitis by systemic tetracycline. J Clin Periodontol10:465-486.
109.
Slots J., Reynolds HS, Genco RJ (1980). Actinobacillus actinomycetemcomitans in human periodontal disease: a cross-sectional, microbiological investigation. Infect Immun29:1013-1020.
110.
Snyder ML (1940). A simple colorimetric method for the estimation of relative numbers of lactobacilli in the saliva. J Dent Res19:349-355.
111.
Snyder ML, Porter DR, Claycomb CK, Sims W., Macho FR (1963). Evaluation of laboratory tests for the estimation of caries activity. Arch Oral Biol8:541-547.
112.
Socransky SS (1968). Caries-susceptibility tests. In: Evaluation of agents used in the prevention of oral diseases. Vol. 153. Hall TL, editor. New York: The New York Academy of Sciences, pp. 137-147.
113.
Socransky SS, Haffajee AD (1992). The bacterial etiology of destructive periodontal disease: Current concepts. J Periodontol63:322-331.
114.
Socransky SS, Haffajee AD (1993). Effect of therapy on periodontal infections. J Periodontol64:754-759.
115.
Spitznagel J. Jr, Kraig E., Kolodrubetz D. (1995). The regulation of leukotoxin production in Actinobacillus actinomycetemcomitans strain JP2. Adv Dent Res9:48-54.
116.
Steiner M., Helfenstein U., Marthaler TM (1992). Dental predictors of high caries increment in children. I Dent Res71:1926-1933.
117.
Tanner A. (1991). Microbial succession in the development of periodontal disease. In: Periodontal disease. Pathogens & host immune responses. Hamada S, Holt SC, McGhee J, editors. Tokyo: Quintessence Publishing Co., Ltd., pp. 13-26.
118.
Tanner A., Lai C-H., Maiden M. (1991). New methods for microbial screening in the diagnosis of periodontal infections: cultural, immunological, gene probes. In: Risk markers for oral diseases. Vol. 3. Periodontal diseases. Johnson NW, editor. Cambridge: Cambridge University Press, pp. 389-414.
119.
Thylstrup A., Fejerskov O. (1994). Textbook of clinical cariology. 2nd ed. Copenhagen: Munksgaard.
120.
Tsai C.-C, Taichman NS (1986). Dynamics of infection by leukotoxic strains of Actinobacillus actinomycetemcomitans in juvenile periodontitis. J Clin Periodontol13:330-331.
van Houte J. (1980). Bacterial specificity in the etiology of dental caries. Int Dent J30:305-326.
123.
van Houte J. (1983). Are the concepts proposed for dental plaque formation valid? In: Cariology Today. Guggenheim B, editor. Basel: Karger, pp. 183-190.
124.
van Houte J. (1994). Role of micro-organisms in caries etiology. J Dent Res73:672-681.
125.
van Houte J., Gibbons RJ, Pulkkinen AJ (1972). Ecology of human oral lactobacilli. Infect Immun6:723-729.
126.
van Winkelhoff AJ, van Steenbergen Tjm, de Graaff J. (1988a). The role of black-pigmented Bacteroides in human oral infections. J Clin Periodontol15:145-155.
127.
van Winkelhoff AJ, van der Velden U., de Graaff J. (1988b). Microbial succession in recolonizing deep periodontal pockets after a single course of supra- and subgingival debridement. J Clin Periodontol15:116-122.
128.
van Winkelhoff AJ, Pavicic Mjamp, de Graaff J. (1993). Antibiotics in periodontal therapy. lst European Workshop on Periodontology, Feb. 1-4, 1993. Ittingen CH, Lang NP, Karring T, editors. London: Quintessence Publishing Co., Ltd., pp. 258-273.
129.
van Winkelhoff AJ, de Groot P., Abbas F., de Graaff J. (1994). Quantitative aspects of the subgingival distribution of Actinobacillus actinomycetemcomitans in a patient with localized juvenile periodontitis. J Clin Periodontol21:199-202.
130.
Walker C, Gordon ) (1990). The effect of clindamycin on the microbiota associated with refractory periodontitis. J Periodontol61:692-698.
131.
Wikström M., Renvert S., Dahlén G., Johnsson T. (1991). Variance in recovery of periodontitis-associated bacteria caused by sampling technique and laboratory processing. Oral Microbiol Immunol6:102-106.
132.
Wyss C. ( 1989). Dependence of proliferation of Bacteroides forsythus on exogenous N-acetylmuramic acid. Infect Immun57:1757-1759.
133.
Zambon JJ (1985). Actinobacillus actinomycetemcomitans in human periodontal disease. J Clin Periodontol12:1-20.
134.
Zambon JJ, DeLuca C., Slots J., Genco RJ (1983). Studies of leukotoxin from Actinobacillus actinomycetemcomitans using the promyelocytic HL-60 cell line. Infect Immun40:205-212.
